Background/Objectives: Severe jawbone atrophy, particularly in elderly or medically compromised patients, presents a significant challenge for conventional implant placement. In cases where bone augmentation is not feasible, alternative techniques—such as short, narrow, tilted, and zygomatic implants—may be indicated for the rehabilitation of the atrophic jaw. Subperiosteal implants have re-emerged as a further viable alternative, especially with recent advancements in digital planning and custom fabrication. This study aims to evaluate the clinical outcomes and complications associated with subperiosteal implants through a literature review and a supporting case series, and to propose clinical preliminary guidelines for their use. Methods: Fourteen studies—including case reports, case series, retrospective studies, and systematic reviews—were analyzed to assess the effectiveness and risk profile of subperiosteal implants. Additionally, we present a case series of nine patients with advanced vertical and horizontal alveolar bone atrophy treated using custom-made, digitally-designed subperiosteal implants. Surgical techniques, prosthetic workflows, and complications were recorded and assessed. Results: Subperiosteal implants were found to be particularly suitable for patients with narrow alveolar crests and severe atrophy where traditional implants are contraindicated. Literature and case series data indicated favorable outcomes, with early complications such as soft tissue inflammation and prosthetic misfit being manageable. A low complication rate was recorded in our series, with digital workflows contributing to improved implant fit and reduced technical errors. Conclusions: Subperiosteal implants could offer an effective solution for complex atrophic cases, provided that patient selection, surgical precision, and prosthetic design are meticulously managed. Based on our findings, clinical recommendations are proposed to guide their application in contemporary practice.

Background/Objectives: Osseointegration of titanium dental implants is essential for the long-term success of prosthetic treatments. Cold atmospheric pressure plasma (CAP) has recently emerged as a promising surface modification technique aimed at enhancing early osseointegration by improving implant surface properties and exerting antimicrobial effects. This systematic review aims to critically evaluate the in vivo preclinical evidence on the effects of CAP or similar cold plasma treatments on titanium dental implant surfaces with regard to osseointegration outcomes. Methods: A systematic literature search was conducted in PubMed and Scopus databases for preclinical in vivo studies published between 2005 and 2025 investigating the effects of cold plasma on titanium dental implant surfaces. The primary outcome assessed was the bone-to-implant contact (BIC), followed by secondary outcomes including implant stability quotient (ISQ), removal torque, bone area fraction occupancy (BAFO), peri-implant bone density (PIBD), interfacial bone density (IBD), bone-implant direct weight (BDWT) and bone loss measurements via histology and micro-CT. Risk of bias was evaluated using the SYRCLE Risk of Bias tool. Results: Nine eligible studies involving 310 titanium implants in 71 animal models (dogs, pigs and mice) were included. CAP-treated implants consistently demonstrated significant improvements in early osseointegration parameters compared to controls, with statistically significant increases in BIC (up to +20%), BAFO and biomechanical fixation metrics (removal torque and ISQ). Micro-CT analyses revealed enhanced peri-implant bone density and architecture. No adverse biological events or implant failures related to plasma treatment were reported. However, heterogeneity in plasma protocols, animal species and short follow-up durations (2–12 weeks) limited comparability and long-term interpretation. Conclusions: Preclinical evidence seems to support CAP as a safe and potentially effective surface treatment for enhancing early osseointegration of titanium dental implants. Further standardized long-term studies involving functional loading and clinical trials in humans are needed to confirm clinical efficacy and optimize treatment protocols.

Patients undergoing oral surgery are frequently polymedicated and preoperative prescriptions (analgesics, corticosteroids, antibiotics) can generate clinically significant drug–drug interactions (DDIs) associated with bleeding risk, serotonin toxicity, cardiovascular instability and other adverse events. This study prospectively evaluated whether large language models (LLMs) can assist in detecting clinically relevant DDIs at the point of care. Five LLMs (ChatGPT-5, DeepSeek-Chat, DeepSeek-Reasoner, Gemini-Flash, and Gemini-Pro) were compared with a panel of experienced oral surgeons in 500 standardized oral-surgery cases constructed from realistic chronic medication profiles and typical postoperative regimens. For each case, all chronic and procedure-related drugs were provided and the task was to identify DDIs and rate their severity using an ordinal Lexicomp-based scale (A–X), with D/X considered “action required”. Primary outcomes were exact agreement with surgeon consensus and ordinal concordance; secondary outcomes included sensitivity for actionable DDIs, specificity, error pattern and response latency. DeepSeek-Chat reached the highest exact agreement with surgeons (50.6%) and showed perfect specificity (100%) but low sensitivity (18%), missing 82% of actionable D/X alerts. ChatGPT-5 showed the highest sensitivity (98.0%) but lower specificity (56.7%) and generated more false-positive warnings. Median response time was 3.6 s for the fastest model versus 225 s for expert review. These findings indicate that current LLMs can deliver rapid, structured DDI screening in oral surgery but exhibit distinct safety trade-offs between missed critical interactions and alert overcalling. They should therefore be considered as decision-support tools rather than substitutes for clinical judgment and their integration should prioritize validated, supervised workflows.

Prevention of peri-implantitis involves the early diagnosis of peri-implant mucositis. This article presents a protocol of hygienic maintenance in different implant prosthetic scenarios: single crown, fixed partial prosthesis, fixed full-arch, and overdentures. Others clinical conditions have to be taken into consideration: patient compliance; history of periodontitis; implants placed in augmented bone; short, zygomatic, pterygoid, and tilted implants; and complex prosthesis with false gingiva. Two levels of implant maintenance are described: ordinary, performed by dental hygienist, and extraordinary, carried out by both dentist and hygienist. Extraordinary maintenance also involves the removal and decontamination of the prosthetic structure. To obtain an effective prevention of peri-implantitis, one must plan ordinary and extraordinary hygiene in relation to the type of rehabilitation and clinical parameters.

Implant-supported prosthetic rehabilitation for patients with severely atrophic jaws is challenging due to complex anatomical considerations and the limitations of conventional augmentation techniques. This study explores the potential of subperiosteal (juxta-osseous) implants as an alternative solution, using finite element analysis (FEA) to evaluate mechanical performance. Realistic jaw models, developed from radiographic data, are utilized to simulate various implant configurations and load scenarios. Results indicate that different screw placements, implant designs, and structural modifications can significantly influence stress distribution and biomechanical behavior. Upper and lower jaw models were assessed under multiple load conditions to determine optimal configurations. Findings suggest that strategic adjustments, such as adding posterior screws or altering implant connections, can enhance load distribution and reduce stress concentration, particularly in critical areas. Tensile loads in critical bone areas near cortical fixing screws exceeded 50 MPa under anterior loading, while configurations with larger load distributions reduced stress on both implant and bone. The study provides evidence-based insights into optimizing subperiosteal implant design to improve stability, longevity, and patient outcomes.

The use of collagen membranes has remained the gold standard in GTR/GBR. In this study, the features and the biological activities of an acellular porcine dermis collagen matrix membrane applicable during dental surgery were investigated, and also by applying hydration with NaCl. Thus, two tested membranes were distinguished, the H-Membrane and Membrane, compared to the control cell culture plastic. The characterization was performed by SEM and histological analyses. In contrast, the biocompatibility was investigated on HGF and HOB cells at 3, 7, and 14 days by MTT for proliferation study; by SEM and histology for cell interaction study; and by RT-PCR for function-related genes study. In HOBs seeded on membranes, mineralization functions by ALP assay and Alizarin Red staining were also investigated. Results indicated that the tested membranes, especially when hydrated, can promote the proliferation and attachment of cells at each time. Furthermore, membranes significantly increased ALP and mineralization activities in HOBs as well as the osteoblastic-related genes ALP and OCN. Similarly, membranes significantly increased ECM-related and MMP8 gene expression in HGFs. In conclusion, the tested acellular porcine dermis collagen matrix membrane, mainly when it is hydrated, behaved as a suitable microenvironment for oral cells.